title: What do people appreciate in physicians' communication? An international study with focus groups using videotaped medical consultations.
abstract: BACKGROUND
  The literature shows that the quality of communication is usually determined from a professional perspective. Patients or lay people are seldom involved in the development of quality indicators or communication.
  
  
  OBJECTIVE
  To give voice to the lay people perspective on what constitutes 'good communication' by evoking their reactions to variations in physician communication.
  
  
  METHODS
  Lay people from four different countries watched the same videotaped standardized medical encounters and discussed their preferences in gender-specific focus groups who were balanced in age groups.
  
  
  METHODS
  Two hundred and fifty-nine lay people (64 NL, 72 IT, 75 UK and 48 BE) distributed over 35 focus groups of 6-8 persons each.
  
  
  METHODS
  Comments on doctors' behaviours were classified by the GULiVer framework in terms of contents and preferences.
  
  
  RESULTS
  Participants prevalently discussed 'task-oriented expressions' (39%: competency, self-confident, providing solutions), 'affective oriented/emotional expressions' (25%: empathy, listening, reassuring) and 'process-oriented expressions' (23%: flexibility, summarizing, verifying). 'Showing an affective attitude' was most appreciated (positive percentage within category: 93%, particularly facilitations and inviting attitude), followed by 'providing solution' (85%). Among disfavoured behaviour, repetitions (88%), 'writing and reading' (54%) and asking permission (42%) were found.
  
  
  CONCLUSIONS
  Although an affective attitude is appreciated by nearly everybody, people may vary widely in their communication needs and preferences: what is 'good communication' for one person may be disliked or even a source of irritation for another. A physician should be flexible and capable of adapting the consultation to the different needs of different patients. This challenges the idea of general communication guidelines.
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Mazzi
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Rimondini
authors.affiliation: Department of General Practice and Primary Health Care, University of Ghent, Ghent, Belgium.
authors.forename: Myriam
authors.initials: M
authors.lastname: Deveugele
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Christa
authors.initials: C
authors.lastname: Zimmermann
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Moretti
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht University, Utrecht, The Netherlands.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: van Vliet
authors.affiliation: Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Deledda
authors.affiliation: Division of Health Research, Lancaster University, Lancaster, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Fletcher
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht University, Utrecht, The Netherlands.
authors.forename: Jozien
authors.initials: J
authors.lastname: Bensing
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D003142:Communication; D004644:Emotions; D005060:Europe; D005260:Female; D017144:Focus Groups; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology*; D010817:Physician-Patient Relations; D014743:Videotape Recording; D055815:Young Adult
keywords: focus groups; patient perspective; physician communication; qualitative and quantitative analyses; videotaped consultations